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m dr. Evan bola einem mamuni. Im a maternal fetal medicine specialist and i i work here at the center for maternal fetal medicine at howard county.
If you overweight and considering a pregnancy. I think the best thing to do is to go in and speak with your primary care physician or come in and speak with us in maternal fetal medicine. There are degrees to obesity and the more severe the obesity.
The more difficult of pregnancy can be if you are overweight. And you can calculate something called your body mass index basically by knowing your height and your weight. And there are many applications online that you can use to check.
But ideal is to be below 25. Many women in this country particularly are not below 25 for their bmi. As its called and so many women fall in that 25 to 30 range.
Which is overweight. But not obese for those women. Increasing exercise.
Watching their diet would probably be sufficient so obesity in pregnancy can affect both mom and baby for mom. The risks to being obese starting off the pregnancy are an increased risk for diabetes or high blood sugar. An increased risk for blood pressure issues particularly high blood pressure and a condition called preeclampsia.
Which involves high blood pressure with protein in the urine that can sometimes lead to a preterm delivery. Because mom has gotten very sick.
And so we would prefer that moms have worked on their weight before getting pregnant for baby. The risks of maternal obesity are that babies can be very small in size. They also could be very large.
But we see the small babies. More often and the babies are at risk for still birth particularly late in the pregnancy. We dont have a good explanation for why this happens.
But it seems to occur in larger moms. And so the more that we can control it from the beginning the better off we are so in order to manage the risks of obesity if youve gotten pregnant and you find yourself in this situation. What we ask is that you come in so that you can speak with the nutritionist.
So that we can follow your diet closely so we can monitor you for any signs of diabetes. So we can keep a close eye on babys size by doing ultrasounds a little bit more frequently than the average pregnant woman and also we often monitor our moms that have a bmi greater than 40 at the very end of the pregnancy by doing non stress tests and fluid evaluations of the baby just to keep an eye and try and identify those babies that would do better on the outside. So if you are obese.
And youre thinking about becoming pregnant. We welcome you to come in and speak with us before getting pregnant. What we would do for you is assess your weight and possible risks to the pregnancy.
Discuss those with you on an individual basis. And help you get set up with a nutritionist maybe with the weight loss plan an exercise program to help you lose weight before becoming pregnant. And then we would be able to follow you closely once you became some other disorders related to ocd these might be like a more specific type of ocd this includes body dysmorphic disorder.
Which has a high prevalence in women also higher in patients that are prominent at derm clinics or cosmetic surgery patients in body dysmorphic disorder. People have perceived flaws and the physical appearance and they often act upon those flaws excoriation disorder or compulsive skin picking as another ocd related disorder.
This can present like we saw on that picture on the previous slide. Lets go back to that real quick. Where a patient has all these lesions all over their skin.
Where they picked their skin and again thats an ego disk tonic. Ocd disease. That is not something that a person wants to do they feel like they have to pick their skin maybe they feel like theyre infested with bugs.
But thats excoriation disorder. Next is hoarding as an ocd related disorder in hoarding. A patient cannot discard their possessions regardless of the value of their possessions.
Which largely leads to them accumulating trash and you can treat hoarding with specialized cbt trichotillomania is a hair. Pulling disorder. You can see hair loss like you see in that picture on the right here person pulled out their hair in a specific area.
And it leads to showing of the scalp on their head trichotillomania. You can treat that again with specialized cbt with habit reversal training ssris and some atypical antipsychotics might be useful here too so these are diseases that are related to ocd sometimes thought of as more specific variations of ocd ptsd as the next disease. Were talking about mental disorder occurring after exposure to trauma such as sexual assault warfare other types of violence and traffic collisions symptoms characteristic of ptsd include increased reactivity irritability difficulty concentrating hyper vigilance exaggerated startle reactions and difficulty with sleep people with ptsd might avoid triggers of their symptoms.
They might know that something triggers them like loud noises or perhaps a gush of water or being splashed. Sometimes in ptsd must last for at least one month. Similar to ptsd or kind of the short term version of ptsd is acute stress disorder.
This is a ptsd like condition with similar symptoms similar avoidance of triggers except that the trauma occurred less than one month ago. And the symptoms have been lasting for less than one month so oftentimes acute stress disorder evolves into ptsd after one month following the trauma treatment for ptsd is psychotherapy again cbt specifically exposure therapy and cognitive processing.
Therapy. Pharmacotherapy can again also be helpful specifically ssris and snris you can also use prazosin to treat nightmares. Specifically thats an alpha blocker that could be used to treat.
One of the symptoms nightmares of ptsd adjustment disorder as the last disease. Well be talking about this is a very common disorder and occurs in up to 20 of people often treated in the outpatient setting patients are unable to cope with stress or a major life event. Sometimes of adjustment disorder include loss of interest.
Crying feelings of hopelessness often times. Some of the symptoms youll see in major depressive disorder. Sometimes typically occur within three months of the stressor such as moving to a new town or getting a new job or losing your job.
And the symptoms should resolve by six months after that stressor symptoms. Result of when the patient finally deps to that new situation finally gets another job or gets another girlfriend or adjusts to living in chicago. Or whatever.
The initial stressor was times acute or sometimes adjustment disorder. Is called situational depression jessamyn disorder. Can generally be treated with supportive therapy.
You can consider temporary medications. Especially for some of the symptoms. Like insomnia.
You can tell them to take melatonin or anxiety depression. You might give ssris for a bit of the time. But usually supportive therapy is all thats needed if theres a very very targetable stressor a very obvious stressor thats causing the person to stress with adjustment.
This has been a short video on anxiety ptsd ocd and related psychiatric disorders. I hope this was helpful and thank you for listening .
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